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Changes in insulin requirements during pregnancy in Japanese women with type 1 diabetes

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Abstract

Aims

We investigated the changes in insulin requirements, and other relevant factors, in pregnant Japanese women with type 1 diabetes.

Methods

This retrospective observational study was conducted on 77 singleton pregnant women with type 1 diabetes, treated with multiple daily injections of insulin. We examined changes in daily insulin dose during pregnancy and defined the increased insulin doses as the ratio of maximum dose to the pre-pregnancy dose. The relationship between the increased insulin doses and maternal features or pregnancy outcomes was investigated.

Results

The insulin dose gradually increased during pregnancy, reaching a maximum dose that was 1.6 times of that prior to pregnancy, at 35 weeks of gestation. A negative significant correlation was observed between the insulin dose increases and duration of diabetes (p = 0.008). Greater increases in insulin doses were noted in women with multiparity, compared to nulliparity (p = 0.047). Multiple regression analyses revealed that shorter duration of diabetes was independently associated with the increases in insulin dose during pregnancy.

Conclusions

Women with a longer duration of diabetes required smaller increases in insulin dose during pregnancy, suggesting that long diabetic duration may decrease placental function. Further investigations are needed to clarify the mechanisms that the duration of diabetes influences on insulin requirement during pregnancy.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Keiko Yanagisawa.

Ethics declarations

Conflict of interest

Author Babazono received lecture fees from MSD K.K., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Phama Ltd., Takeda Pharma Ltd., Mitsubishi Tanabe Pharma Corp, Astellas Pharma Inc., Chugai Pharma Manufacturing Co., Ltd., Boehringer Ingerheim, Astra Zeneca K.K., Otsuka Pharmacuetical Co., Ltd., Kowa Shinyaku Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., and Daiichi Sankyo Co., Ltd., and research grants from Novartis Phama K.K., Astellas Pharma Inc., Pfizer Japan Inc., Chugai Pharma Manufacturing Co., Ltd., Boehringer Ingerheim, Astra Zeneca K.K., Kyowa Hakko Kirin Co., Ltd., Alcon, Otsuka Pharmacuetical Co., Ltd., Nipro; Eli Lilly Japan K.K., Kowa Shinyaku Co., Ltd., Eizai Co., Ltd., Takeda Pharma Ltd., Sanofi K.K., Mitsubishi Tanabe Pharma Corp., MSD K.K., Ono pharmaceutical Co., Novo Nordisk Phama Ltd., Terumo Corp., Sumitomo Dainippon Pharma Co., Ltd., and Daiichi Sankyo Co., Ltd. Other authors declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study. This study was approved by the Ethical Committee of Tokyo Women’s Medical University School of Medicine (Approval No. 3920R, approval date: 2 June 2017).

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Kambara, M., Yanagisawa, K., Tanaka, S. et al. Changes in insulin requirements during pregnancy in Japanese women with type 1 diabetes. Diabetol Int 10, 102–108 (2019). https://doi.org/10.1007/s13340-018-0369-8

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  • DOI: https://doi.org/10.1007/s13340-018-0369-8

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